Abstract Details

Title High Prevalence of Insomnia and Shift Work in Cluster Headache

Topic Headache

Presentation(s) P03 - (-)

Poster/Presentation
Number 106

Objective

Background BACKGROUND: Cluster headache is a chronobiological disorder. Arctic Norway has around 450.000 inhabitants, and is essentially served by only two neurological departments.

Design/Methods DESIGN/METHODS: Through a retrospective chart review at Nordland Hospital Trust and the University Hospital of Tromso, all subjects diagnosed with Episodic Cluster Headache (ICD-10 G 44.0) between January 1st 2000 and December 31st 2010 were traced. Patients with a confirmed diagnosis (ICHD-2) received a comprehensive questionnaire covering demographic data, clinical characteristics, sleep and periodicity of attacks.

Results RESULTS: A total of 206 subjects were registered, and 180 received the questionnaire. Fifty-eight men (age 49.2 ±13.6) and 12 women (age 49.7 ± 15.5) responded positively. Forty percent of the responders suffered from chronic insomnia (DSM-IV), and almost half of both responders (46 %) and non-responders (at least 40%) reported current shift work or previous shift work for years. Insomnia was significantly associated with self-reported stressed-type personality (p=0.012) and experiencing longer lasting cluster bouts (p=0.017), but not with self-defined chronotype (p=1.000), co-morbidity (p=0.078) or shift work (p=0.194). One third attributed their insomnia to the cluster headache. In general, responders reported sleep (49%), sharp light (47%), alcohol (31%), lack of sleep (19%) and supine position (16%) as the major triggers for attacks. Shift workers were significantly more likely to see lack of sleep as a cluster attack trigger than daytime workers (p=0.045). Insomniacs did not report lack of sleep as a trigger more often than non-insomniacs (p=0.357).

Conclusions CONCLUSIONS: Chronic insomnia among Arctic cluster headache patients is common. The present study indicates that shift work may cause circadian misalignment and predispose for cluster headache. The high prevalences of insomnia and shift work found should be confirmed in other cluster populations.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
Svein I. Bekkelund (Dept of Neuro/Tromso Univ Hosp)	No disclosure on file
Karl Bjornar Alstadhaug, MD	No disclosure on file
	No disclosure on file

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